The role of vitamin D in pre-eclampsia: a systematic review

Abstract

BackgroundThe etiology of pre-eclampsia (PE) is not yet fully understood, though current literature indicates an upregulation of inflammatory mediators produced by the placenta as a potential causal mechanism. Vitamin D is known to have anti-inflammatory properties and there is evidence of an inverse relationship between dietary calcium intake and the incidence of PE. Evidence of the role of vitamin D status and supplementation in the etiology and prevention of PE is reviewed in this article along with identification of research gaps to inform future studies.MethodsWe conducted a structured literature search using MEDLINE electronic databases to identify published studies until February 2015. These sources were retrieved, collected, indexed, and assessed for availability of pregnancy-related data on PE and vitamin D.ResultsSeveral case-control studies and cross-sectional studies have shown an association between vitamin D status and PE, although evidence has been inconsistent. Clinical trials to date have been unable to show an independent effect of vitamin D supplementation in preventing PE.ConclusionsThe included clinical trials do not show an independent effect of vitamin D supplementation in preventing PE; however, issues with dose, timing, and duration of supplementation have not been completely addressed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1408-3) contains supplementary material, which is available to authorized users.

The effect of VDR gene polymorphisms and vitamin D level on blood pressure, risk of preeclampsia, gestational age, and body mass index

“…Also, a significantly higher percentage of patients (75%) had an insufficient level of 25 (OH)-D compared with controls (53.7%, P = 0.003). 5 In a study from India, the maternal 25 (OH)-D concentration was negatively associated with blood pressure and the risk of preeclampsia; although, the severity of preeclampsia was not associated with vitamin D status. Consistent with our findings, it has been reported that there is a significant inverse association between systolic blood pressure and the level of 25 (OH)-D among adults.…”

“…However, the severity of preeclampsia was not related to the vitamin D level. 5 An inverse relationship between the plasma levels of 25 (OH)-D and increased risk of developing hypertension 17 and essential hypertension have been reported. Further, the insufficient level of vitamin D (<20 ng/mL) compared with sufficient level (20-30 ng/mL) resulted in significantly higher systolic blood pressure.…”

“…Consistent with our findings, it has been reported that there is a significant inverse association between systolic blood pressure and the level of 25 (OH)-D among adults. 5 Among Colombian women, low maternal concentrations of 25 (OH)-D increased the risk of preeclampsia. In a normal pregnancy, RAS is induced.…”

“…3 Abnormal placentation and uteroplacental circulation, along with endothelial cell dysfunction, are known risk factors to be involved in the pathogenesis of preeclampsia. 5 Also, an inverse relationship between plasma 1, 25 (OH)2-D3 level and blood pressure has been found. 5 Also, an inverse relationship between plasma 1, 25 (OH)2-D3 level and blood pressure has been found.…”

“…5 However, studies related to the association between vitamin D status and preeclampsia are inconsistent. 9 The VDR gene consists of two promoter regions, eight coding exons (namely, [2][3][4][5][6][7][8][9], and six untranslated exons (1A-1F). For effective interaction of VDR with DNA, the receptor requires heterodimerization with auxiliary proteins known as the retinoid-X receptors.…”